Original Title: iFR/FFR and IVUS-guided percutaneous coronary revascularization with new-generation DES in patients with de novo three-vessel disease: 30-day outcomes of the SYNTAX II trial.
Presenter: P. W. Serruys.
The European Society of Cardiology guidelines recommend PCI for patients with multivessel disease and a Syntax score. A prospective, multicenter, single arm study was carried out on patients with three vessel disease with no left main compromise by angiogram.
The study included patients with SYNTAX score II recommendation for PCI, or at least equipoise between PCI and CABG, based on predicted mortality at 4 years. The control group was created by applying SYNTAX score II to the PCI group of the original SYNTAX trial. Primary end point was a combination of major adverse cardiovascular and cerebrovascular events (MACCE) at one year.
Functional analyzis of lesions with FFR/iFR revealed that 23%, with prior revascularization based on anatomical data, only required medical treatment. 2% of lesions could not be revascularized for technical issues and the remaining 75% received PCI.
MACCE analyzis at 30 days showed lower stent thrombosis incidence (2.5% vs. 0.4%, p=0.019) and lower infarction incidence (4.1% vs. 0.2%, p<0.001) with contemporary PCI vs. the original SYNTAX outcomes.
Conclusion
IVUS y FFR/IFR guided PCI with SYNERGY stent in patients with multivessel disease resulted in better incidence of MI and thrombosis vs. the control group from the original SYNTAX study.
